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COMMUNICABLE
DISEASE CONTROL
PUBLIC HEALTH
NURSING
VITAL
STATISTICS
ENVIRONMENTAL
HEALTH
HEALTH
EDUCATION
802 SHERIDAN PORT TOWNSEND, WASH. 98368
(206) 385.0722
HEALTH BOARD
Minutes of May 21, 1991
BOARD MEMBERS:
STAFF MEMBERS:
B. G. Brown, Chairman
Larry W. Dennison, Member
Richard E. Wojt, Member
Larry Fay, Director of
Environmental Health
David Specter, Health Department
Administrator
Nancy Gow, Acting Director of
Nursing Services
J. Peter Geerlofs, M.D.,
Health Officer
CITY OF PORT TOWNSEND
REPRESENTATIVE:
Sheila Westerman
The meeting was called to order at the appointed time by Chairman BoG.
Brown. The follo\,!ing Board and staff members were present Commissioner Larry
Dennison; David Specter; Larry Fay; Nancy Gow; Peter Geerlofs; and Environmental
Technician Marel Harstad. Commissioner Richard Wojt was absent.
APPROVAL OF MINUTES: Commissioner Larry Dennison moved to
approve the Minutes of April 16, 1991 as presented, Chairman Brown seconded the
motion which carried by unanimous vote.
L.-
Health Board Minutes - May 21, 1991
Page: 2
ADMINISTRATOR'S REPORT
Financial Report: David Specter presented the current "Budget Status
Report". The Professional Services line of the budget appears high because the
expenditures aren't evenly distributed throughout the year, especially in the dental
program, and Travel may be under-budgeted.
Proaram/Grant Update: David Specter updated the Board:
*
Consolidated Contract: About $5,000 in additions for the cash portion
of the consolidated contract has been received to date.
*
Vaccines: Nancy Gow explained that now the actual dollar value of
vaccine used will be accounted for as a line item to satisfy Federal
requirements. The vaccine dollar amounts will now be detailed in the
grants.
*
Dental Program: The Dental Program, which is intended to provide
primary care in the form of education, prevention, hygiene, and minimal
restorative work, was reviewed. The program difficulties were discussed.
The current program ends June 30th, and the next begins in September.
*
Interagency Coordinating Council (lAC): The grant for lAC has been
submitted for 1992, and is being awarded at $2,800. This is the last year
for the lAC grant. Alternative funding sources were discussed: United
Good Neighbors has been approached for the Birth to Six portion of the
program; and the school districts have been contacted for the Birth to
Three portion.
Automated Billina System: David Specter reported that improvements
to the automated billing system are being reviewed; staff has attended State training
sessions; systems in Thurston County are being looked at; and the Human Services
Department system is being considered as they have software for Medicaid billing.
The experience of Human Services and other Health Departments is that they are
getting a five or six fold increase in efficiency, and time saved by going with automated
software programs.
Health Board Minutes - May 21, 1991
Page: 3
ADMINISTRATOR'S REPORT. Continued:
Facilities Update: David Specter, Public Works Director Gary Rowe,
and Facilities Manager Frank Gifford met to discuss options to deal with temporary
space needs while permanent space is arranged. Of the possibilities explored, Public
Works is investigating the leasing of a building space for 18 months to two years. The
Health Department staff explored what portion of the department could be separated
from the current space. They determined that they do not want to move any functions
that would involve changing the location for the public. The nursing staff office
functions could most easily be relocated. The nursing staff would have to come to the
department for clinics and then return to their office to do phone calls, and records.
An option to relocating the nursing staff would be to provide a portable building which
could be placed behind the hospital. David Specter considered this the ideal option
as an interim measure as the existing phones could be tied in, the staff would be
close, clinic equipment wouldn't need to be installed, and the time pressure to get
immediate space would be relieved. A discussion of options, office changes, continuity
of service, and what was best for the staff was held.
APEX: Assessment Protocol for Excellence in Public Health: David
Specter reported that APEX representatives met with each of the Board Members and
the Health Officer to identify the issues regarding implementing the program. The
common issues were time and cost. He explained that Phase One would require
253 staff hours, which includes 40 hours of clerical time. The first phase will take
three to four months and the staff hours needed would be spread out over this time.
The second phase would basically use the administrator's time, with staff time needed
for reviews.
Suggestions for finding the needed staff time, effect on service, community
involvement, and the possibility of finding a graduate student to collect odd data and
provide analysis as an intern project were discussed. Beginning in September, a part-
time clerk hire position may be needed. The specific costs of implementing APEX are
not available yet. Chairman BoG. Brown requested that the costs be provided to the
Board as soon as possible. Commissioner Dennison noted that the County would
initially be investing time for a more efficient system and better service.
Commissioner Dennison moved to approve the first step of implementing the
Assessment Protocol for Excellence in Public Health program. Chairman Brown
seconded the motion which carried by unanimous vote.
Health Board Minutes - May 21, 1991
Page: 4
DIRECTOR OF NURSING'S REPORT
Statistics - Monthlv Report: In 1990 the Maternity Support Program
income was about $8,600 a month. The program collected $11,300 in May. Nancy
Gow stated that an increase in staff would be covered.
Infant Mortality and Birthweight Rates Report: Nancy Gow explained that
an article by Carolyn Latteier appeared in the May 14, 1991 "Bremerton SUN", that
stated the infant mortality rate in Jefferson County is one of the highest in the state.
She noted that the rates are high with an increase in number over the past five years.
The data on all the deaths is not available yet, but two of the infant deaths in 1989
were from Sudden Infant Death Syndrome (SIDS). The staff will be looking more
closely at the statistics and causes of infant mortality. In terms of the Maternity
Support Program, it appears that it is functioning as it should be.
HIV Testing: Nancy Gow reported that HIV testing statistics show 22 tests
and counseling sessions in 1990, while to date in 1991 there have been 58.
Measles Mumps Rubella (MMR) Immunization: Nancy Gow commented that
MMR clinics are being done for the fifth graders this year and the sixth graders next
year. Theses clinics will need to be held every year. The response has been good.
The statistics show that countywide nearly 13% of the children have exemptions signed
by their parents for MMR. She stated that this means about 13% of the school
children aren't adequately immunized. Of these children, less than 1% percent of the
exemptions are for medical reasons; the majority being for religious or personal
reasons.
Staffina Update: The Family Planning Nurse Practitioner is taking
maternity leave. A Health Department employee has been hired to fill in.
DIRECTOR OF ENVIRONMENTAL HEALTH'S REPORT
Draft Solid Waste Permit. Jefferson County Landfill: Larry Fay
reported that a discussion of the proposed Solid Waste Permit for the County Landfill
was scheduled with guests from the Department of Ecology: Sandra Lange, Solid
Waste Planner; Cris Matthews, Solid Waste Hydrologist; and Kirk Cook, Solid Waste
Supervisor.
Health Board Minutes. May 21, 1991
Page: 5
DIRECTOR OF ENVIRONMENTAL HEALTH'S REPORT - Continued:
Commissioner Larry Dennison excused himself as he had a previously scheduled
appointment. Chairman B. G. Brown noted that the meeting would be informational
as the Health Board no longer had a quorum.
Larry Fay stated that the Health Department has been permitting the landfill over the
last few years pending a request for variances from the minimal function standards.
Pending adoption of the County's Comprehensive Solid Waste Plan, the facility has to
be properly permitted. Meetings to determine the approach to take to adopt a permit
have been scheduled. The Draft Permit includes a compliance schedule to get the
landfill facility operating within the framework of minimal function standards. The
tentative date for closure of the Landfill is January 1993, with closure of the Black
Lagoon set for September 1991. He noted that if dates are determined and agreed
upon, then the permit can go through and the Solid Waste Plan can be approved.
Kirk Cook commented that the counties need to plan based on the future, and that the
draft permit provides dates and a time mechanism to work with. The Department of
Ecology needs to have a plan of operation in the form of a permit. Not having a
plan creates obstacles to grant funding. He stated that a realistic plan that is
acceptable to the County, the Health Department, and the Department of Ecology is
-sought. It was noted that by State Law the Department of Ecology's duty is to provide
technical assistance to counties and to help them get into compliance with regulations.
Cris Matthews commented that the public landfill is almost up to capacity, and that
there is a sense of urgency regarding containment of septage as the community does
have some wells around the landfill.
Further discussion was held regarding viable alternatives and costs.
*******
The next regular meeting will be held Tuesday, June 18, 1991 at the Basement
Conference Room.
MEETING ADJOURNED
JEFFERSON COUNTY BOARD OF HEALTH
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Ef.G. Br wn, Chairman La
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